- State of Colorado (CO)
- Fee -for- Service Claims & Payment Models Business Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4902755) Apply Fee ... to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs . https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs We are looking for a Fee -for- Service Claims & Payment… more
- Molina Healthcare (San Antonio, TX)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... to provider contracting, network management, credentialing, benefits, prior authorizations, fee schedules, and other business requirements critical to claim… more
- University of Rochester (Rochester, NY)
- …calls, payer website, and written communication to ensure accurate processing of claims . Follows established procedure for missing insurance payment information ... expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative II is responsible for working across the… more
- UCLA Health (Los Angeles, CA)
- …+ High School Diploma, GED or equivalent experience + Four or more years of medical claims payment experience in an HMO setting + Expertise in industry standard ... and the review and adjudication of professional, ancillary, and institutional claims for services rendered in our inpatient, ambulatory and outpatient settings.… more
- Lakeshore Bone & Joint Institute (Crown Point, IN)
- …inputs on trends in denials, non-covered services, prior authorizations, and deductibles or co- payment collection issues at the point of service . + Complete ... to keep moving and keep enjoying their life. The Payment Poster is responsible for posting medical payments through...and ERA's match payments. + Report and reroute denied claims to the appropriate coding and denial management team… more
- University of Rochester (Rochester, NY)
- …as to why claims are not paid and steps necessary for processing/ payment . - - Initiate collection phone calls to insurance companies to determine reason for ... claim denial or reason for unpaid claim. Address unpaid claims , and solicit a payment date from...determine final resolution.- - - Re-calculate claim based on fee schedule, APC or APG grouper, appropriate % of… more
- NCR VOYIX (Atlanta, GA)
- …rights and that annuity/maintenance fee information and instructions to third-party payment service providers are up-to-date and accurate + Develop and ... whether QPIDS may be available + Reviewing EP granted claims for accuracy and coordinating the process for validating...ensure that all relevant information is included (eg, issue fee payment dates, dates of issuance, election… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …laws. + Quick learner with ability to grasp managed care procedures and claims payment policies. + Detail-oriented and dependable. + Effective listening and ... claims inquiry, claim reconsiderations and appeals. The Customer Service Representatives must be able to work in various...call center, experience with claims inquiry and claims review procedures, knowledge of medical specialties, fee… more
- Houston Methodist (Houston, TX)
- …the revenue cycle teams to follow up on missing data that may delay claims submission and payment . Collaborates with internal CBO department and Account Managers ... and claim edits, payor rejections, unresolved or no response insurance claims and processing of financial correspondence. The Insurance Biller demonstrates general… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …+ Experience in revenue cycle management, including the handling of insurance claims , payment postings, insurance follow up, denial and appeals processes. ... reporting for approximately $30 million in client and third-party fee revenues, and supports the Fiscal Team of the...stakeholders to resolve denial matters. Performs research for rejected claims to assess the root cause, proposes solutions and… more